WO2003066044A1

WO2003066044A1 - New medicinal compositions containing heterocyclical compounds in addition to anticholinergics

Info

Publication number: WO2003066044A1
Application number: PCT/EP2003/000961
Authority: WO
Inventors: Christopher John Montague Meade; Michel Pairet; Michael P. Pieper
Original assignee: Kyowa Hakko Kogyo Co., Ltd.
Priority date: 2002-02-08
Filing date: 2003-01-31
Publication date: 2003-08-14
Also published as: AR038824A1; AU2003205717A1; DE10205274A1; US20030203918A1; PE20030932A1; TW200303866A; UY27651A1

Abstract

The invention relates to novel medicinal compositions on the basis of anticholinergics (1) and compounds of formula (2), in which the radicals A, B, D, R1, R2, R3, R4, and R5 can have the meanings mentioned in the claims and the description, methods for the production thereof, and the use thereof for treating respiratory diseases.

Description

New drug compositions containing in addition to anticholinergics heterocyclic

links

The present invention relates to novel drug compositions based on anticholinergics 1 and heterocyclic compounds of formula 2

wherein the radicals A, B, D, R ¹ , R ² , R ³ , R ⁴ and R ⁵ may have the meanings mentioned in the claims and in the description, processes for their preparation and their use in the treatment of respiratory diseases.

Description of the Invention The present invention relates to novel drug compositions based on anticholinergics and the heterocyclic compounds of formula 2

wherein the radicals A, B, D, R ¹ , R ² , R, R ⁴ and R ⁵ may have the meanings mentioned in the claims and in the description, processes for their preparation and their use in the treatment of respiratory diseases.

The compounds of the formula 2 are known from WO 96/36624. Surprisingly, an unexpectedly advantageous therapeutic effect, in particular a synergistic effect in the treatment of inflammatory and / or obstructive respiratory diseases, can be observed if one or more, preferably one anticholinergic, together with one or more, preferably one Compound of formula 2 are used. Because of this synergistic effect, the drug combinations according to the invention can be used at a lower dosage than is the case with the otherwise customary monotherapy of the individual compounds.

The above-mentioned effects are observed both with simultaneous administration within a single drug formulation as well as with successive application of the two drugs in separate formulations. According to the invention, the simultaneous application of the two active ingredient components in a single formulation is preferred.

Accordingly, one aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2

embedded image in which

R, ι ¹ hydrogen, methyl, ethyl, n-butyl, i-butyl, phenyl, 2-ethylphenyl, 2-i-propylphenyl, benzyl, 4-pyridyl, 2-pyridyl, -CO-phenyl, CN, or together with R ^{2 is} a butylene or pentylene bridge; R ^{2 is} hydrogen, methyl, ethyl, or together with R ^{1 is} a butylene or pentylene bridge, or together with R ^{13 is} a single bond or a butylene bridge;

R ^{3 is} hydrogen;

R ^{4 is} methoxy; R ^{5 is} cyclohexyl, phenyl, 3-methoxycarbonylphenyl, 4-methoxycarbonylphenyl, 3-carboxyphenyl, 4-carboxy-phenyl, CN, -COOH, -COOMe, -COOEt, 3,5-dichloro-pyridin-4-yl, 4-pyridyl or 4 -pyridyl-N-oxide;

A is oxygen or -CH ₂ -;

B is oxygen or one of the groups -C (R ¹² ) (R ¹³ ) - or -CH (R ¹⁵ ) -CH (R ¹⁷ ) -; D is a group selected from -CH-CH ₂ -, -CH (Ph) -CH ₂ -, -CONH-,

-CO-CH ₂ -, -CH = CH-, -C (Ph) = CH-, -C (CR ¹⁸ ) (CR ¹⁹ ) -X-, -C (R ^19a ) = Y-,

-CfC- or phenylene; R ^{12 is} hydrogen, methyl, ethyl, i-propyl, phenyl or -CH ₂ -COR ^x ; R ^{13 is} hydrogen or, together with R ^2, a single bond or a butylene bridge; R ¹⁵ is hydrogen or together with R ¹⁷ is a single bond;

R ^{17 is} hydrogen or together with R ¹⁵ a single bond;

R .1 ¹ 8 ^{0 is} hydrogen or methyl;

R ^{19 is} hydrogen, methoxy, phenyl or CN;

R ^{19a is} hydrogen, methyl or phenyl;

R ^{x is} hydroxy, ethoxy, benzyloxy, 2-phenylethyloxy, 4-methylpiperazin-1-yl, 4-phenylpiperazin-1-yl, N-tetrahydroisoquinolinyl, -NH-phenyl, -NH-benzyl,

-NH-CH ₂ - (4-methoxyphenyl), -NH-CH ₂ - (4-fluorophenyl), -NH-CH ₂ - (4-chlorophenyl), -NH-CH ₂ - (2-chlorophenyl), -NH - (3-pyridyl) -, -NH-CH ₂ - (2-pyridyl), -NH-CH ₂ - (3-pyridyl), -NH-CH ₂ - (4-pyridyl), -NH- (3, 5-dichloropyridin-4-yl) or -NH- (2-pyrimidinyl); X is -CH ₂ -, -S- or -NH-

Y may be CH, CCN, CCOOEt or CHCONH, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

Compounds of the general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy and in which A is oxygen, B is the group -C (R ¹² ) (R ¹³ ) - and D is the group -CONH-, have the general formula 2a

on.

A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2a

embedded image in which

R ^{1 is} hydrogen, n-butyl, benzyl, 4-pyridyl, 2-pyridyl, -CO-phenyl or CN; R ^{2 is} hydrogen or together with R ¹³ a single bond; R ^{5 is} cyclohexyl, phenyl, 3,5-dichloro-pyridin-4-yl or 4-pyridyl; R ^{12 is} hydrogen, methyl, ethyl, i-propyl, phenyl or -CH ₂ -COR; R ^{13 is} hydrogen or together with R ² a single bond; R ^{x is} hydroxy, ethoxy, benzyloxy, 2-phenylethoxy, 4-methylpiperazin-1-yl, 4-phenylpiperazin-1-yl, N-tetrahydroisoquinolinyl, -NH-phenyl, -NH-benzyl,

-NH-CH ₂ - (4-methoxyphenyl), -NH-CH ₂ - (4-fluorophenyl), -NH-CH ₂ - (4-chloroethyl), -NH-CH ₂ - (2-chlorophenyl), - NH- (3-pyridyl) -, -NH-CH ₂ - (2-pyridyl), -NH-CH ₂ - (3-pyridyl), -NH-CH ₂ - (4-pyridyl), -NH- (3 , 5-dichloropyridin-4-yl) or -NH- (2-pyrimidinyl), optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic agent 1, contains one or more, preferably one compound of the general formula 2a, which is selected from the compounds according to Table 1. Table 1: Particularly preferred compounds of the formula 2a

Compounds of the general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy and in which A is oxygen, B is the group -C (R ¹² ) (R ¹³ ) - and D is the group -C (R ¹⁸ ) ( R ¹⁹ ) -X-, have the general formula 2b

on. A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2b

embedded image in which

R ^{1 is} hydrogen, methyl, ethyl or 4-pyridyl, or together with R a butylene bridge; R ^{2 is} hydrogen, methyl, ethyl, or together with R ¹ a butylene bridge, or together with R ¹³ a single bond;

R is 3,5-dichloro-pyridin-4-yl or 4-pyridyl; R _{2 is} hydrogen or methyl; R 13 is hydrogen or together with R a single bond;

R 18 is hydrogen or methyl; R 19 is hydrogen, methoxy, phenyl or CN; X is -CH ₂ -, -S- or -NH-, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic agent 1, contains one or more, preferably one compound of the general formula 2b, which is selected from the compounds according to Table 2. Table 2: Particularly preferred compounds of formula 2b

Compounds of general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy and in which A is oxygen, B is the group -C (R ¹² ) (R ¹³ ) - and D is the group -C (R ^19a ) = Y-, have the general formula 2c

on. A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2c

wherein

R ^{1 is} hydrogen, methyl, ethyl, phenyl, 4-pyridyl, 2-pyridyl, or together with R ^2, a butylene or pentylene bridge; R ^{2 is} hydrogen, methyl, ethyl, or together with R ^{1 is} a butylene or pentylene bridge, or together with R ^{13 is} a single bond; R ^{5 is} 3-methoxycarbonylphenyl, 4-methoxycarbonylphenyl, 3-carboxyphenyl,

4-carboxyphenyl, CN, -COOEt, 3,5-dichloro-pyridin-4-yl or 4-pyridyl; R ^{12 is} hydrogen or methyl; R ^{13 is} hydrogen or together with R ² a single bond; R ^{19a is} hydrogen, methyl or phenyl;

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic agent 1, contains one or more, preferably a compound of the general formula 2c, which is selected from the compounds according to Table 3. Table 3: Particularly preferred compounds of the formula 2c

Compounds of the general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy and in which A is oxygen, B is the group -C (R ¹² ) (R ¹³ ) - and D is the group -CO-CH-, have the general formula 2d

on.

A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2d

wherein

R is hydrogen, methyl, ethyl, n-butyl, isobutyl, phenyl, 2-ethyl-phenyl,

2-i-propyl-phenyl, 4-pyridyl, 2-pyridyl, -CO-phenyl, CN, or together with R ² a butylene or pentylene bridge;

R ^{2 is} hydrogen, methyl, ethyl, or together with R ^{1 is} a butylene or pentylene bridge, or together with R ^{13 is} a single bond or a butylene bridge;

R ⁵ is phenyl, 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

R 12 is hydrogen, methyl, phenyl or -CH ₂ -COR ^x ;

R 13 is hydrogen or, together with R ^2, a single bond or a butylene bridge; R ^x ethoxy, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic agent 1, contains one or more, preferably a compound of the general formula 2d, selected from the compounds according to Table 4.

Table 4: Particularly preferred compounds of formula 2d

Compounds of the general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy and in which A is oxygen and B is the group -CH (R ¹⁵ ) -CH (R ¹⁷ ) -, have the general formula 2e

2e on.

A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2e

embedded image in which

R methyl or together with R a butylene or pentylene bridge;

R ^{z is} methyl or together with R ^{1 is} a butylene or pentylene bridge;

R ^{5 is} 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

D is a group selected from -CONH-, -CO-CH ₂ - or -CH = CH-;

R 15 is hydrogen or together with R ¹⁷ a single bond; R 17 may be hydrogen or together with R 15 is a single bond, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic 1, contains one or more, preferably one compound of the general formula 2e which is selected from the compounds according to Table 5.

Table 5: Particularly preferred compounds of the formula 2e

Compounds of the general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy, in which A is -CH ₂ - and B is oxygen and in which R ¹ and R ² together form a butylene bridge, have the general formula 2f

on.

A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2f

wherein

R ^{5 is} 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

D may be a group selected from -CONH-, -CO-CH ₂ - or -CH = CH-, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic agent 1, contains one or more, preferably a compound of the general formula 2f, which is selected from the compounds according to Table 6. Table 6: Particularly preferred compounds of the formula 2f

Compounds of the general formula 2 in which R ^{3 is} hydrogen and R ^{4 is} methoxy, in which A and B are oxygen and R ¹ and R ² together form a butylene bridge, have the general formula 2g

on.

A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with one or more, preferably a compound of general formula 2g

Wonn

R ^{5 is} 3,5-dichloro-pyridin-4-yl or 4-pyridyl; D can represent a group selected from -CH ₂ -CH ₂ -, -CH (Ph) -CH ₂ -, -CONH-, -CO-CH ₂ -, -CH = CH- or -C (Ph) = CH- , optionally in the form of the individual optical isomers, mixtures thereof or racemates, and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic 1, contains one or more, preferably a compound of the general formula 2g, which is selected from the compounds according to Table 7.

Table 7: Particularly preferred compounds of the formula 2g

Compounds of the general formula 2, in which R ^{3 is} hydrogen and R ^{4 is} methoxy, in which A is oxygen and B is -CH ₂ - in which R ¹ and R ² together form a butylene bridge and in which the group -DR ^{5 represents} the group W, the general formula 2h

on.

A preferred aspect of the present invention relates to a pharmaceutical composition characterized by a content of an anticholinergic 1 in combination with a compound of general formula 2h

Wonn w is a radical selected from the group consisting of

optionally, in the form of the individual optical isomers, mixtures thereof or racemates, and optionally in the form of their pharmacologically acceptable acid addition salts.

The present invention particularly preferably relates to a medicament which, in addition to an anticholinergic agent 1, contains one or more, preferably a compound of the general formula 2h, which is selected from the compounds according to Table 8.

Table 8: Particularly preferred compounds of the formula 2h

Reference to the above compounds 2 in the context of the present invention includes a reference to their optionally existing pharmacologically acceptable acid addition salts. Among the physiologically acceptable acid addition salts which can be formed from 2 are understood according to the invention pharmaceutically acceptable salts which are selected from the salts of hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, methanesulfonic acid, acetic acid, fumaric acid, succinic acid, lactic acid, citric acid, tartaric acid or maleic acid , According to the invention, the salts of the compounds 2 which are selected from the group consisting of acetate, hydrochloride, hydrobromide, sulfate, phosphate, and methanesulfonate are preferred.

In the context of the present invention, anticholinergics 1 are understood as meaning salts which are preferably selected from the group consisting of tiotropium salts, oxitropium salts and ipratropium salts, particular preference being given to tiotropium salts. In the salts mentioned above, the cations tiotropium, oxitropium and ipratropium are the pharmacologically active ingredients. In the context of the present patent application, a reference to the above cations by the use of the designation T is to be regarded. Reference to compounds 1 includes, of course, a reference to components V - (tiotropium, oxitropium or ipratropium).

Salts 1 which can be used in the context of the present invention are understood as meaning the compounds which, in addition to tiotropium, oxitropium or ipratropium, contain as counterion (anion) chloride, bromide, iodide, methanesulphonate or para-toluenesulphonate. In the context of the present invention, of all salts 1, the methanesulfonate, chloride, bromide or iodide are preferred, the methanesulfonate or the bromide being of particular importance. Of outstanding importance according to the invention are salts 1, which are selected from the group consisting of tiotropium bromide, oxitropium bromide and ipratropium bromide. Particularly preferred is the tiotropium bromide. The application of the medicament combinations according to the invention from 1 and 2 is preferably carried out by inhalation. In this case, suitable inhalable powders which are filled into suitable capsules (inhalettes) by means of appropriate powder inhalers may be used. Alternatively, inhalation application can also be carried out by application of suitable inhalation aerosols. These include inhalation aerosols, which contain, for example, HFA134a (also called TG134a), HFA227 (also called TG227) or their mixture as propellant gas. The inhalative application can also be carried out by means of suitable solutions of the drug combination consisting of 1 and 2.

Another aspect of the present invention relates to a pharmaceutical composition containing one or more salts 1 and one or more compounds 2, optionally in the form of their solvates or hydrates. With particular preference, the crystalline tiotropium bromide monohydrate is used for the salts 1. Again, the active ingredients may be contained either together in a single dosage form or in two separate dosage forms. Preferred according to the invention are medicaments which contain active substances 1 and 2 in a single administration form.

Another aspect of the present invention relates to a pharmaceutical composition which contains, in addition to therapeutically effective amounts of 1 and 2, a pharmaceutically acceptable excipient. A further aspect of the present invention relates to a pharmaceutical which, in addition to therapeutically effective amounts of 1 and 2, contains no pharmaceutically acceptable excipient.

The present invention further relates to the use of 1 and 2 for the preparation of a therapeutically effective amount of 1 and 2 containing medicament for the treatment of inflammatory and / or obstructive pulmonary diseases, in particular of asthma or chronic obstructive pulmonary disease (COPD), as well as their complications such as pulmonary Hypertension, as well as allergic and non-allergic rhinitis.

The present invention is further directed to the simultaneous or successive use of therapeutically effective doses of the combination of the above drugs 1 and 2 for the treatment of inflammatory and / or obstructive airways diseases, in particular asthma or chronic obstructive pulmonary disease (COPD), as well their complications such as pulmonary hypertension, besides allergic and non-allergic rhinitis, by simultaneous or successive application.

In the active compound combinations according to the invention from 1 and 2, the constituents 1 and 2 may be present in the form of their enantiomers, mixtures of the enantiomers or in the form of the racemates.

The conditions in which the two active compounds 1 and 2 can be used in the active compound combinations according to the invention are variable. The active compounds 1 and 2 can optionally be in the form of their solvates or hydrates. Depending on the choice of compounds 1 and 2, the weight ratios which can be used in the context of the present invention vary due to the different molecular weight of the various compounds and due to their different potency. As a rule, the medicament combinations according to the invention can contain the compounds 1_ and 2 in weight ratios which lie in a range from 1: 300 to 50: 1, preferably from 1: 250 to 40: 1. In the most preferred drug combinations containing tiotropium salt as compound 1, the weight ratios of 1 to 2 are more preferably in a range in which tiotropium V and 2 in ratios of 1: 150 to 30: 1, further preferably from 1:50 to 20: 1 are included.

For example, and without limiting the scope of the invention thereto, preferred combinations of 1 and 2 according to the invention may contain tiotropium T and the compound of formula 2 in the following weight ratios: 1: 80; 1:79; 1: 78; 1:77; 1:76; 1: 75; 1:74; 1: 73; 1:72; 1:71; 1:70; 1: 69; 1: 68; 1:67; 1:66; 1:65; 1:64; 1:63 1:62; 1: 61; 1:60; 1:59; 1:58; 1:57; 1:56; 1:55; 1:54; 1:53; 1:52; 1:51; 1:50; 1:49; 1:48; 1:47; 1:46; 1:45; 1:44; 1:43; 1:42; 1:41; 1:40; 1:39; 1:38; 1:37; 1:36; 1:35; 1:34; 1:33; 1:32; 1:31; 1:30; 1:29; 1:28; 1:27; 1:26; 1:25; 1: 24; 1:23; 1:22; 1:21; 1:20; 1:19; 1:18; 1:17; 1:16; 1:15; 1:14; 1:13; 1:12; 1:11; 1:10; 1: 9; 1: 8; 1: 7; 1: 6; 1: 5; 1: 4; 1: 3; 1: 2; 1: 1; 2: 1; 3: 1; 4: 1; 5: 1; 6: 1; 7: 1; 8: 1; 9: 1; 10: 1; 11: 1; 12: 1; 13: 1; 14: 1; 15: 1; 16: 1; 17: 1; 18: 1; 19: 1; 20: 1.

The use of the medicaments according to the invention containing the combinations of 1 and 2 is usually carried out so that 1 and 2 together in dosages of 0.01 to lOOOOμg, preferably from 0.1 to 2000μg, more preferably from 1 to 1500μg, further preferably from 50 to 1200μg per single dose are included. For example, combinations of 1 and 2 according to the invention contain such an amount of tiotropium V_ and Compound of formula 2 that the total dosage per single dose lOOμg, 105μg, HOμg, 115μg, 120μg, 125μg, 130μg, 135μg, 140μg, 145μg, 150μg, 155μg, 160μg, 165μg, 170μg, 175μg, 180μg, 185μg, 190μg, 195μg, 200μg, 205μg, 210μg, 215μg, 220μg, 225μg, 230μg, 235μg, 240μg, 245μg, 250μg, 255μg, 260μg, 265μg, 270μg, 275μg, 280μg, 285μg, 290μg, 295μg, 300μg, 305μg, 310μg, 315μg, 320μg, 325μg, 330μg, 335μg, 340μg, 345μg, 350μg, 355μg, 360μg, 365μg, 370μg, 375μg, 380μg, 385μg, 390μg, 395μg, 400μg, 405μg, 410μg, 415μg, 420μg, 425μg, 430μg, 435μg, 440μg, 445μg, 450 μg, 455 μg, 460 μg, 465 μg, 470 μg, 475 μg, 480 μg, 485 μg, 490 μg, 495 μg, 500 μg, 505 μg, 510 μg, 515 μg, 520 μg, 525 μg, 530 μg, 535 μg, 540 μg, 545 μg 575 μg, 580 μg, 585 μg, 590 μg, 595 μg, 600 μg, 605 μg, 610 μg, 615 μg, 620 μg, 625 μg, 630 μg, 635 μg, 640 μg, 645 μg, 650 μg, 655 μg, 660 μg, 665 μg, 670 μg, 675 μg, 680 μg, 685 μg, 690 μg, 695 μg, 700 μg, 705 μg, 710 μg, 715 μg, 720 μg, 725 μg, 730 μg, 735 μg, 740 μg, 745 μg, 750 μg, 755 μg, 760 μg, 765 μg, 770 μg, 775 μg, 780 μg, 785 μg, 790 μg, 795 μg, 800 μg, 810 μg, 815 μg, 820 μg, 825 μg, 830 μg, 835 μg, 840 μg, 845 μg, 850 μg, 855 μg, 860 μg, 865 μg, 870 μg, 875 μg, 880 μg, 885 μg, 890 μg, 895 μg, 900 μg, 905 μg, 910 μg, 915 μg, 920 μg, 925 μg, 930 μg, 935μg, 940μg, 945μg, 950μg, 955μg, 960μg, 965μg, 970μg, 975μg, 980μg, 985μg, 990μg, 995μg, 100μg, 1005μg, 10μg, 1015μg, 1020μg, 1025μg, 1030μg, 1035μg, 1040μg, 1045μg, 1050μg, 1055μg, 1060μg, 1065μg, 1070μg, 1075μg, 1080μg, 1085μg, 1090μg, 1095μg, 1 lOOμg or the like. The above

Dosage suggestions per single dose are not to be regarded as limited to the explicitly stated numerical values, but serve only as dosages disclosed by way of example. Of course, for example, dosages to o.g. Numerical values in a range of about +/- 2.5 micrograms vary, including the presently exemplified values. In these dosage ranges, the active ingredients T and 2 can be contained in the weight ratios described above.

For example, and without limiting the scope of the invention thereto, the inventive combinations of 1 and 2 may contain such an amount of tiotropium V_ and compound of formula 2 that 5μg V and 25 μg 2, 5μg V and 50μg 2, 5μg V per single dose and lOOμg 2, 5μg V and 200μg 2, 5μg r and 300μg 2, 5μg V and 400μg 2, 5μg r and 500μg 2, 5μg V and 600μg 2, 5μg V and 700μg 2, 5μg V and 800μg 2, 5μg r and 900μg 2, 5μg V and lOOOμg 2, 10μg V and 25μg 2, 10μg r and 50μg 2, 10μg T and l00μg 2, 10μg r and 200μg 2, 10μg V and 300μg 2, 10μg r and 400μg 2, 10μg V and 500μg 2, 10μg V and 600μg 2, 10μg V and 700μg 2, 10μg V and 800μg 2, 10μg V and 900μg 2, 10μgT and 100μg 2, 18μg r and 25μg 2, 18μg V and 50μg 2, 18μgr and 100μg 2, 18μg T and 200μg 2, 18μg T and 300μg 2, 18μg T and 400μg 2, 18μg r and 500μg2, 18μg r and 600μg 2, 18μg V and 700μg 2, 18μg T and 800μg 2, 18μgT and 900μg 2, 18μg r and lOOOμg 2, 20μg r and 25 μg 2, 20 μg T and 50 μg 2, 20 μg r and 100 μg 2, 20 μg r and 200 μg 2, 20 μg T and 300 μg 2, 20 μg T and 400 μg 2, 20 μg F and 500 μg 2, 20 μg r and 600 μg 2, 20 μg and 700 μg 2, 20μg T and 800μg 2, 20μg r and 900μg 2, 20μg r and 100μg 2, 36μg T and 25μg 2, 36μg T and 50μg 2, 36μg r and 100μg 2, 36μg r and 200μg 2, 36μg T and 300μg 2, 36μg r and 400μg 2, 36μg T and 500μg 2, 36μg T and 600μg 2, 36μg T and 700μg 2, 36μg T and 800μg 2, 36μg JT and 900μg 2, 36μg T and 100μg 2, 40μg r and 25μg 2, 40μg T and 50μg 2, 40μg F and lOOμg 2, 40μg r and 200μg 2, 40μg T un d 300μg 2, 40μg T and 400μg 2, 40μg T and 500μg 2 or 40μg V and 600μg 2, 40μg r and 700μg 2, 40μg V and 800μg 2, 40μg V and 900μg 2, 40μg V and 100μg 2 are applied.

If the combination of active substances 1 and 2 preferred according to the invention is used as the tiotropium bromide, the active substance amounts of V and 2 applied by way of example correspond to the following amounts of 1 and 2: 6 μg 1 and 25 μg 2 administered per single administration. 6 μg 1 and 50 μg 2, 6 μg 1 and 1 μg 2, 6 μg 1 and 200 μg 2, 6 μg 1 and 300 μg 2, 6 μg 1 and 400 μg 2, 6 μg 1 and 500 μg 2, 6 μg 1 and 600 μg 2, 6 μg 1 and 700 μg 2, 6 μg 1 and 800μg 2, 6μg 1 and 900μg 2, 6μg 1 and lOOOμg 2, 12μg 1 and 25μg 2, 12μg 1 and 50μg 2, 12μg l and lOOμg 2, 12μg 1 and 200μg 2, 12μg 1 and 300μg 2, 12μg 1 and 400μg 2, 12μg 1 and 500μg 2, 12μg 1 and 600μg 2, 12μg 1 and 700μg 2, 12μg 1 and 800μg 2, 12μg 1 and 900μg 2, 12μg 1 and lOOOμg 2, 21,7μg 1 and 25μg 2, 21,7μg 1 and 50μg 2, 21,7μg 1 and lOOμg 2, 21,7μg 1 and 200μg 2, 21,7μg 1 and 300μg 2, 21,7μg 1 and 400μg 2, 21,7μg 1 and 500μg 2, 21, 7μg 1 and 600μg 2, 21, 7μg 1 and 700μg 2, 21, 7μg 1 and 800μg 2, 21, 7μg 1 and 900μg 2, 21,7μg 1 and 100μg 2, 24,1 μg 1 and 25μg 2, 24,1 μg 1 and 50μg 2, 24.1 μg 1 and 100μg 2, 24, lμg 1 and 200μg 2, 24, lμg 1 and 300μg 2, 24, lμg 1 and 400μg 2, 24, lμg 1 and 500μg 2, 24, lμg 1 and 600μg 2, 24.1 μg 1 and 700 μg 2, 24.1 μg 1 and 800 μg 2,

24.1 μg 1 and 900 μg 2, 24.1 μg 1 and 1000 μg 2, 43.3 μg 1 and 25 μg 2, 43.3 μg 1 and 50 μg 2, 43.3 μg 1 and 100 μg 2, 43.3 μg 1 and 200 μg 2, 43.3μg 1 and 300μg 2, 43.3μg 1 and 400μg 2, 43.3μg 1 and 500μg 2, 43.3μg 1 and 600μg 2, 43.3μg 1 and 700μg 2, 43.3μg 1 and 800μg 2, 43, 3μg 1 and 900μg 2, 43.3 μg 1 and 100μg 2, 48, lμg 1 and 25 μg 2, 48, lμg 1 and 50μg 2, 48.1 μg 1 and 100μg 2, 48.1 μg 1 and 200μg 2, 48.1 μg 1 and 300 μg 2, 48, lμg l and 400μg 2, 48, lμg l and 500μg 2, 48, lμg 1 and 600μg 2, 48, lμg 1 and 700μg 2, 48.1 μg 1 and 800μg 2, 48.1 μg 1 and 900μg 2 or 48.1 μg 1 and 1 000 μg 2.

If the combination of active substances 1 and 2 preferred according to the invention is used as the tiotropium bromide monohydrate, the active ingredient amounts of Y_ and 2 applied by way of example correspond to the following amounts of 1 and 2 administered per single administration: 6.2 μg 1 and 25 μg 2 , 6.2 μg 1 and 50 μg 2, 6.2 μg 1 and 100 μg 2, 6.2 μg 1 and 200 μg 2, 6.2 μg 1 and 300 μg 2, 6.2 μg 1 and 400 μg 2, 6.2 μg 1 and 500 μg 2, 6 , 2μg 1 and 600μg 2, 6,2μg 1 and 700μg 2, 6,2μg 1 and 800μg 2, 6,2μg 1 and 900μg 2, 6,2μg 1 and lOOOμg 2, 12,5μg 1 and 25μg 2, 12,5μg 1 and 50μg 2, 12.5μg 1 and 100μg 2, 12.5μg 1 and 200μg 2, 12.5μg 1 and 300μg 2, 12.5μg 1 and 400μg 2, 12.5μg 1 and 500μg 2, 12.5μg 1 and 600μg 2, 12.5μg 1 and 700μg 2, 12.5μg 1 and 800μg 2, 12.5μg 1 and 900μg 2, 12.5μg 1 and 100μg 2, 22.5μg 1 and 25μg 2, 22.5μg 1 and 50μg 2 , 22.5μg 1 and 100μg 2, 22.5μg 1 and 200μg 2, 22.5μg 1 and 300μg 2, 22.5 μg 1 and 400 μg 2, 22.5 μg 1 and 500 μg 2, 22.5 μg 1 and 600 μg 2, 22.5 μg 1 and 700 μg 2, 22.5 μg 1 and 800 μg 2, 22.5 μg 1 and 900 μg 2, 22.5 μg I and 100 μg 2, 25 μg 1 and 25 μg 2, 25 μg 1 and 50 μg 2, 25 μg 1 and 100 μg 2, 25 μg 1 and 200 μg 2, 25 μg 1 and 300 μg 2, 25 μg 1 and 400 μg 2, 25 μg 1 and 500 μg 2, 25 μg 1 and 600 μg 2, 25 μg 1 and 700 μg 2, 25 μg 1 and 800 μg 2, 25 μg 1 and 900 μg 2, 25 μg 1 and 100 μg 2, 45 μg 1 and 25 μg 2, 45 μg 1 and 50 μg 2, 45 μg 1 and 100 μg 2, 45 μg 1 and 200μg 2, 45μg 1 and 300μg 2, 45μg 1 and 400μg 2, 45μg 1 and 500μg 2, 45μg 1 and 600μg 2, 45μg 1 and 700μg 2, 45μg 1 and 800μg 2, 45μg 1 and 900μg 2, 45μg 1 and 100μg 2, 50 μg 1 and 25 μg 2, 50 μg 1 and 50 μg 2, 50 μg 1 and 100 μg 2, 50 μg 1 and 200 μg 2, 50 μg 1 and 300 μg 2, 50 μg 1 and 400 μg 2, 50 μg 1 and 500 μg 2, 50 μg 1 and 600 μg 2, 50μg 1 and 700μg 2, 50μg 1 and 800μg 2, 50μg 1 and 900μg 2 or 50μg 1 and lOOOμg 2.

The application of the active compound combinations according to the invention from 1 and 2 is preferably carried out by inhalation. For this purpose, ingredients 1 and 2 must be provided in inhaled dosage forms. As inhalable dosage forms come inhalation powder, propellant-containing

Metered aerosols or propellant-free inhalable solutions into consideration. Inventive inhalable powders comprising the active ingredient combination of 1 and 2 may consist solely of the active substances mentioned or of a mixture of the active substances mentioned with physiologically acceptable excipients. In the context of the present invention, the term propellant-free inhalable solutions also includes concentrates or sterile, ready-to-use inhalation solutions. The administration forms according to the invention may contain the active ingredient combination of 1 and 2 either together in one or in two separate administration forms. These administration forms which can be used in the context of the present invention are described in detail in the following part of the description.

A) Inhalable powder containing the active compound combinations according to the invention from 1 and 2: The inhalable powders according to the invention may contain 1 and 2 either alone or in admixture with suitable physiologically acceptable auxiliaries.

If the active compounds 1 and 2 are mixed with physiologically acceptable excipients, the following physiologically acceptable excipients can be used to prepare these inhalable powders according to the invention: monosaccharides (eg glucose or arabinose), disaccharides (eg lactose, sucrose, maltose), oligo- and Polysaccharides (eg dextrans), polyalcohols (eg sorbitol, mannitol, xylitol), salts (eg sodium chloride, calcium carbonate) or mixtures of these excipients with each other. Preferably, mono- or disaccharides are used, wherein the use of lactose or glucose, in particular, but not exclusively in the form of their hydrates, is preferred. Lactose, most preferably lactose monohydrate, is used as adjuvant for the purposes of the invention.

Within the scope of the inhalable powders according to the invention, the auxiliaries have a maximum mean particle size of up to 250 μm, preferably between 10 and 150 μm, particularly preferably between 15 and 80 μm. If appropriate, it may seem appropriate to add finer excipient fractions having a mean particle size of 1 to 9 .mu.m to the abovementioned excipients. The latter finer excipients are also selected from the aforementioned group of usable excipients. Finally, for the preparation of the inhalable powders according to the invention, micronized active compound 1 and 2, preferably having an average particle size of 0.5 to 10 μm, particularly preferably 1 to 5 μm, are added to the excipient mixture. Methods for producing the inhalable powders according to the invention by grinding and micronizing as well as by final mixing of the constituents are known from the prior art. The inhalable powders of the invention may be provided and applied either in the form of a single powder mixture containing both 1 and 2 or in the form of separate inhalable powders containing only 1 and 2. The inhalable powders according to the invention can be applied by means of inhalers known from the prior art.

Inhalable powders according to the invention, which in addition to 1 and 2 also contain a physiologically acceptable excipient, can be administered, for example, by means of inhalers comprising a single dose from a supply by means of a measuring chamber as described in US 4570630A or by other apparatus such as be described in DE 36 25 685 A, meter. Preferably, the inhalable powders according to the invention, which in addition to 1 and 2 contain physiologically acceptable excipient, however, filled into capsules (called inhalers), which are used in inhalers such as described in WO 94/28958, for example.

A particularly preferred inhaler for use of the medicament combination according to the invention in inhalants is shown in FIG.

This inhaler (Handihaler) for the inhalation of powdered medicines from capsules is characterized by a housing 1, containing two windows 2, a deck 3, in which Lufteinlaßöff are located and which is provided with a strainer 4 mounted on a sieve 5, a with Deck 3 connected inhalation chamber 6, on which a provided with two ground needles 7, is provided against a spring 8 movable pusher 9, and a hinged via an axis 10 with the housing 1, the deck 3 and a cap 11 mouthpiece 12, and Air passage holes 13 for adjusting the flow resistance.

If the inhalable powders according to the invention are to be filled into capsules (inhalettes) for the purposes of the abovementioned preferred application, fillages of from 1 to 30 mg, preferably from 3 to 20 mg, preferably from 5 to 10 mg of inhalable powder per capsule are suitable. These contain according to the invention either together or in each case the doses already mentioned above for 1 and 2 per single dose.

B) propellant gas-containing inhalation aerosols containing fiction, contemporary drug combinations of 1 and 2:

Propellant gas-containing inhalation aerosols according to the invention may contain 1 and 2 dissolved in propellant gas or in dispersed form. Here, 1_ and 2 may be contained in separate dosage forms or in a common dosage form, wherein 1 and either either both dissolved, both dispersed or only one component dissolved and the other dispersed may be included.

The propellant gases which can be used for the preparation of the inhalation aerosols according to the invention are known from the prior art. Suitable propellant gases are selected from the group consisting of hydrocarbons such as n-propane, n-butane or isobutane and

Halogenated hydrocarbons such as fluorinated derivatives of methane, ethane, propane, butane, cyclopropane or cyclobutane. The abovementioned propellant gases can be used alone or in mixtures thereof. Particularly preferred propellants are halogenated alkane derivatives selected from TG 134a and TG227 and mixtures thereof.

The propellant-containing inhalation aerosols according to the invention may contain other ingredients such as co-solvents, stabilizers, surfactants, antioxidants, lubricants and pH adjusters. All of these ingredients are known in the art.

The propellant gas-containing inhalation aerosols according to the invention may contain up to 5% by weight of active compound 1 and / or 2. Aerosols according to the invention contain, for example, 0.002 to 5% by weight, 0.01 to 3% by weight, 0.015 to 2% by weight, 0.1 to 2% by weight, 0.5 to 2% by weight or 0.5 to 1 % By weight of active ingredient 1 and / or 2.

If the active compounds 1 and / or 2 are present in dispersed form, the active substance particles preferably have an average particle size of up to 10 μm, preferably from 0.1 to 5 μm, particularly preferably from 1 to 5 μm.

The abovementioned propellant gas-containing inhalable content inhalers according to the invention can be administered by means of inhalers known from the prior art (MDIs = metered dose inhalers). Accordingly, another aspect of the present invention relates to pharmaceutical compositions in the form of propellant-containing aerosols as described above in association with one or more inhalers suitable for administering these aerosols. Furthermore, the present invention relates to inhalers, characterized in that they contain the propellant-containing aerosols according to the invention described above. The present invention further relates to cartridges which can be equipped with a suitable valve in a suitable inhaler and are used one of the abovementioned propellant gas-containing inhalation aerosols according to the invention. Suitable cartridges and processes for filling these cartridges with the propellant-containing inhalable inhalable aerosols according to the invention are known from the prior art.

Q propellant-free inhalable solutions or suspensions containing active compound combinations according to the invention from 1 and 2:

Particularly preferably, the application of the combination of active substances according to the invention takes place in the form of propellant-free inhalable solutions and content suspension. Suitable solvents for this purpose are aqueous or alcoholic, preferably ethanolic solutions. The solvent may be water only or it may be a mixture of water and ethanol. The relative proportion of ethanol to water is not limited, but the maximum limit is preferably up to 70% by volume, in particular up to 60% by volume and more preferably up to 30% by volume. The remaining volume percentages are filled up with water. The solutions 1 or 2, separately or jointly, are adjusted to a pH of from 2 to 7, preferably from 2 to 5, with suitable acids. To adjust this pH, acids selected from inorganic or organic acids can be used. Examples of particularly suitable inorganic acids are hydrochloric acid, hydrobromic acid, nitric acid, sulfuric acid and / or phosphoric acid. Examples of particularly suitable organic acids are: ascorbic acid, citric acid, malic acid, tartaric acid, maleic acid, succinic acid, fumaric acid, acetic acid, formic acid and / or propionic acid and others. Preferred inorganic acids are hydrochloric acid, sulfuric acid. It is also possible to use the acids which already form an acid addition salt with one of the active substances. Among the organic acids, ascorbic acid, fumaric acid and citric acid are preferable. Optionally, mixtures of said acids may also be employed, particularly in the case of acids which, in addition to their acidification properties, also possess other properties, e.g. as flavorants, antioxidants or complexing agents, such as citric acid or ascorbic acid. Hydrochloric acid is particularly preferably used according to the invention for adjusting the pH.

According to the present invention, the addition of editic acid (EDTA) or one of the known salts thereof, sodium edetate, as a stabilizer or complexing agent can be dispensed with in the present formulation. Other embodiments include these Links). In such a preferred embodiment, the content based on sodium edetate is below 100 mg / 100 ml, preferably below 50 mg / 100 ml, more preferably below 20 mg / 100 ml. In general, those inhalation solutions are preferred in which the content of sodium edetate is 0 to 10 mg / 100 ml.

Co-solvents and / or further auxiliaries can be added to the propellant-free inhalable solutions according to the invention.

Preferred co-solvents are those which contain hydroxyl groups or other polar groups, for example alcohols - in particular isopropyl alcohol, glycols - in particular propylene glycol, polyethylene glycol, polypropylene glycol, glycol ethers, glycerol, polyoxyethylene alcohols and polyoxyethylene fatty acid esters. By auxiliaries and additives is meant in this context any pharmacologically acceptable substance that is not an active ingredient but can be formulated together with the active ingredient (s) in the pharmacologically suitable solvent in order to improve the qualitative properties of the active ingredient formulation. These substances preferably do not develop any appreciable or at least no undesirable pharmacological effect in the context of the intended therapy. The auxiliaries and additives include e.g. surfactants, e.g. Soya lecithin, oleic acid, sorbitan esters such as polysorbates, polyvinylpyrrolidone other stabilizers, complexing agents, antioxidants and / or preservatives containing the

Ensure or prolong the duration of use of the finished drug formulation, flavorings, vitamins and / or other additives known in the art. The additives also include pharmacologically acceptable salts such as sodium chloride as isotonants.

Preferred excipients include antioxidants, such as ascorbic acid, if not already used for pH adjustment, vitamin A, vitamin E, tocopherols, and similar vitamins or pro-vitamins found in the human organism. Preservatives may be used to protect the formulation from contamination by germs. Suitable preservatives are those known in the art, in particular cetylpyridinium chloride, benzalkonium chloride or benzoic acid or benzoates such as sodium benzoate in the concentration known from the prior art. The above-mentioned preservatives are preferably in Concentrations of up to 50mg / 100ml, more preferably between 5 and 20 mg / 100ml.

Preferred formulations contain, apart from the solvent water and the active ingredient combination of 1 and 2, only benzalkonium chloride and sodium edetate. In another preferred embodiment, sodium edetate is dispensed with.

For the application of propellant-free inhalable solutions according to the invention are particularly those inhalers that can nebulise a small amount of a liquid formulation in the therapeutically necessary dosage within a few seconds in a therapeutically inhalation suitable aerosol. In the context of the present invention, preference is given to those foggers in which an amount of less than 100 μL, preferably less than 50 μL, particularly preferably between 20 and 30 μL of active substance solution, preferably one stroke to an aerosol with an average particle size of less than 20 μm, preferably less than 10 μm, can be so atomized that the inhalable fraction of the aerosol already corresponds to the therapeutically effective amount.

Such a device for the propellant-free administration of a metered amount of a liquid medicament for inhalation use is described in detail, for example, in International Patent Application WO 91/14468 as well as in WO 97/12687 (there in particular Figures 6a and 6b). The Vemebler (Devices) described there are also known as Respimat®.

This Vemebler (Respimat®) can be used advantageously for generating the inhalable aerosols according to the invention comprising the active ingredient combination of 1 and 2. Due to its cylindrical shape and a handy size of less than 9 to 15 cm in length and 2 to 4 cm in width, this device can always be carried by the patient. The Vemebler sprays a defined volume of the drug formulation using high pressures through small nozzles to produce inhalable aerosols.

Essentially, the preferred atomizer of an upper housing part, a pump housing, a nozzle, a locking mechanism, a spring housing, a spring and a reservoir, characterized by a pump housing, which is fixed in the upper housing part, and that at its one

End carries a nozzle body with the nozzle or nozzle assembly, a hollow piston with valve body, a driven flange, in which the hollow piston is fixed, and located in the

Upper housing part is located, a locking body, which is located in the upper housing part, a spring housing with the spring therein, which is rotatably mounted on the upper housing part by means of a rotary bearing, a lower housing part, which is mounted on the spring housing in the axial direction.

The hollow piston with Ventilköφer corresponds to a device disclosed in WO 97/12687. It partially protrudes into the cylinder of the pump housing and is arranged axially displaceably in the cylinder. In particular, reference is made to FIGS. 1-4, in particular FIG. 3, and the associated parts of the description. The hollow piston with Ventilköφer exerts on its high pressure side at the time of triggering the spring a pressure of 5 to 60 Mpa (about 50 to 600 bar), preferably 10 to 60 Mpa (about 100 to 600 bar) on the fluid, the measured drug solution. Volumes of from 10 to 50 microliters are preferred, volumes from 10 to 20 microliters are particularly preferred, and a volume of 15 microliters per stroke is very particularly preferred.

The Ventilköφer is preferably attached to the end of the hollow piston, which faces the Düsenköφer.

The nozzle in the nozzle body is preferably microstructured, i. produced by microtechnology. Microstructured nozzle bodies are disclosed, for example, in WO-94/07607; This document is hereby incorporated by reference, in particular to the figure 1 and its description disclosed therein.

The nozzle body consists e.g. of two fixed plates of glass and / or silicon, at least one plate of which has one or more microstructured channels connecting the nozzle inlet side to the nozzle outlet side. On the

Nozzle outlet side is at least one round or non-round opening from 2 to 10

Micrometer depth and 5 to 15 micrometers in width, the depth preferably being 4.5 to 6.5

Micrometers and the length is 7 to 9 microns.

In the case of a plurality of nozzle openings, preferably two, the jet directions of the nozzles in the nozzle body can be parallel to one another or they are in the direction Nozzle opening inclined to each other. In a Düsenköφer with at least two nozzle openings on the outlet side, the beam directions can be inclined at an angle of 20 degrees to 160 degrees to each other, preferably an angle of 60 to 150 degrees, more preferably 80 to 100 °. The nozzle openings are preferably located at a distance of 10 to 200 microns, more preferably at a distance of 10 to 100 microns, more preferably 30 to 70 microns. Most preferred are 50 microns. The jet directions meet accordingly in the vicinity of the Düsenöffhungen.

The liquid pharmaceutical preparation meets with an inlet pressure of up to 600 bar, preferably 200 to 300 bar to the nozzle body and is atomized via the Düsenöffhungen in an inhalable aerosol. The preferred particle or droplet sizes of the aerosol are up to 20 microns, preferably 3 to 10 microns.

The locking mechanism includes a spring, preferably a cylindrical helical compression spring, as a memory for the mechanical energy. The spring acts on the output flange as a jump piece whose movement is determined by the position of a locking member. The path of the output flange is precisely limited by an upper and a lower stop. The spring is preferably transmitted via a force translating gear, e.g. a Schraubschubgetriebe, stretched by an external torque that is generated when turning the upper housing part against the spring housing in the lower housing part. In this case, the upper housing part and the output flange contain a single or multi-start wedge gear.

The locking member with engaging locking surfaces is arranged annularly around the output flange. It consists for example of a radially elastically deformable ring made of plastic or metal. The ring is arranged in a plane perpendicular to the atomizer axis. After tensioning the spring, the locking surfaces of the locking member push in the path of the output flange and prevent the relaxation of the spring. The locking member is triggered by a button. The release button is connected or coupled to the locking member. To trigger the locking mechanism, the shutter button is parallel to the ring plane, and preferably in the atomizer, moved; while the deformable ring is deformed in the ring plane. Constructive details of the locking mechanism are described in WO 97/20590. The lower housing part is pushed in the axial direction over the spring housing and covers the storage, the drive of the spindle and the reservoir for the fluid.

When actuating the atomizer, the housing upper part is rotated against the lower housing part, wherein the lower housing part entrains the spring housing. The spring is compressed and tensioned via the screw slide, and the lock engages automatically. The angle of rotation is preferably an integer fraction of 360 degrees, e.g. 180 degrees. Simultaneously with the tensioning of the spring, the driven part is displaced in the upper housing part by a predetermined path, the hollow piston is withdrawn within the cylinder in the pump housing, whereby a subset of the fluid from the reservoir is sucked into the high-pressure chamber in front of the nozzle.

If necessary, a plurality of interchangeable reservoirs containing the fluid to be atomized can be inserted and used successively in the atomizer. The storage container contains the aqueous aerosol preparation according to the invention.

The sputtering process is initiated by lightly pressing the shutter button. The blocking mechanism clears the way for the stripping section. The tensioned spring pushes the piston into the cylinder of the pump housing. The fluid exits the nozzle of the atomizer in atomized form.

Further design details are disclosed in PCT applications WO 97/12683 and WO 97/20590, the contents of which are hereby incorporated by reference.

The components of the atomizer (Vemeblers) are made of a functionally suitable material. The housing of the atomizer and, as far as the function permits, other parts are preferably made of plastic, e.g. by injection molding. Physiologically harmless materials are used for medical purposes.

In the figures attached to this patent application 2a / b, which are identical to the

Figures 6 a / b of WO 97/12687, the Vemebler (Respimat®) is described, with which the aqueous aerosol preparations according to the invention can be advantageously inhaled.

FIG. 2 a shows a longitudinal section through the atomizer with the spring tensioned, and FIG. 2 b shows a longitudinal section through the atomizer with the spring relaxed. The upper housing part (51) contains the pump housing (52), at the end of which the holder (53) for the atomizer nozzle is mounted. In the holder is the nozzle body (54) and a filter (55). The hollow piston (57) fastened in the output flange (56) of the locking mechanism projects partially into the cylinder of the pump housing. At its end, the hollow piston carries the Ventilköφer (58). The hollow piston is sealed by means of the seal (59). Within the upper housing part is the stop (60) on which the output flange rests with a relaxed spring. At the output flange is the stop (61) on which the output flange rests when the spring is tensioned. After tensioning the spring, the locking member (62) slides between the stop (61) and a support (63) in the upper housing part. The release button (64) is in communication with the locking member. The housing upper part ends in the mouthpiece (65) and is closed with the attachable protective cap (66).

The spring housing (67) with compression spring (68) is rotatably supported by means of the snap lugs (69) and pivot bearing on the upper housing part. About the spring housing, the lower housing part (70) is pushed. Within the spring housing is the replaceable reservoir (71) for the fluid (72) to be atomized. The reservoir is closed with the stopper (73) through which the hollow piston protrudes into the reservoir and with its end immersed in the fluid (stock of drug solution).

In the lateral surface of the spring housing, the spindle (74) for the mechanical counter is mounted. At the end of the spindle, which faces the upper housing part, there is the drive pinion (75). The rider (76) sits on the spindle.

The vemebler described above is suitable for nebulising the aerosol preparations according to the invention to form an aerosol suitable for inhalation.

If the formulation according to the invention is nebulised by means of the technique described above (Respimat®), the applied mass should be at least 97%, preferably at least 98% of all actuations of the inhaler (Hube) of a defined amount with a maximum tolerance of 25%, preferably 20% Amount correspond.

Preferably, between 5 and 30 mg of formulation per stroke are applied as a defined mass, more preferably between 5 and 20 mg. However, the formulation according to the invention may also be aerosolized by means of inhalers other than those described above, for example jet-stream inhalers.

Accordingly, a further aspect of the present invention relates to pharmaceuticals in the form of propellant-free inhalable solutions or suspensions as described above in combination with a device suitable for administering these formulations, preferably in conjunction with the Respimat®. Preferably, the present invention is directed to propellant-free inhalable solutions or suspensions characterized by the combination of active substances 1 and 2 according to the invention in combination with the device known by the name Respimat®. Furthermore, the present invention relates to the above-mentioned devices for inhalation, preferably the Respimat®, characterized in that they contain above-described propellant-free inhalable solutions or suspensions according to the invention.

The propellant-free inhalable solutions or suspensions according to the invention can also be present as concentrates or sterile ready-to-use inhalable solutions or suspensions in addition to the solutions and suspensions provided above for application in the Respimat. For example, ready-to-use formulations can be generated from the concentrates by adding isotonic saline solutions. Sterile ready-to-use formulations can be applied by means of energy-powered, stand-alone or portable vials that generate inhalable aerosols by means of ultrasound or compressed air according to the Venturi principle or other principles.

Accordingly, another aspect of the present invention relates to pharmaceuticals in the form of propellant-free inhalable solutions as described above or

Suspensions, which are in the form of concentrates or sterile ready-to-use formulations, in combination with a device suitable for administering these solutions, characterized in that the device is an energy-powered stand-alone or portable vaporizer, which delivers inhalable aerosols by means of ultrasound or compressed air after Venturi principle or other principles generated.

The following examples serve to further illustrate the present invention without, however, limiting the scope of the invention to the following exemplary embodiments. raw materials

tiotropium bromide:

The tiotropium bromide used in the following formulation examples can be obtained as described in European patent application EP 418 716 A1.

Crystalline tiotropium bromide monohydrate can likewise be used to prepare the inhalable powders according to the invention. This crystalline tiotropium bromide monohydrate is obtainable according to the procedure described below. 15.0 kg of tiotropium bromide are introduced into 25.7 kg of water in a suitable reaction vessel. The mixture is heated to 80-90 ° C and stirred at a constant temperature until a clear solution is formed. Activated carbon (0.8 kg), moist with water, is slurried in 4.4 kg of water, this mixture is added to the tiotropium bromide-containing solution and rinsed with 4.3 kg of water. The resulting mixture is stirred for at least 15 minutes at 80-90 ° C and then filtered through a heated filter in a pre-heated to 70 ° C jacket temperature apparatus. The filter is rinsed with 8.6 kg of water. The contents of the apparatus are cooled at 3-5 ° C per 20 minutes to a temperature of 20-25 ° C. With cold water cooling, the apparatus is further cooled to 10-15 ° C and the crystallization is completed by at least one hour stirring. The crystals are isolated on a Nutschentrockner, washed the isolated crystal slurry with 9 L of cold water (10-15 ° C) and cold acetone (10-15 ° C). The resulting crystals are dried at 25 ° C for 2 hours in a stream of nitrogen. Yield: 13.4 kg tiotropium bromide monohydrate (86% of theory)

The crystalline tiotropium bromide monohydrate thus obtained is micronised by known methods to provide the active ingredient in the form of the average particle size which meets the specifications of the invention. formulation Examples

A) Inhalation powder 1)

2)

3)

4)

5)

6)

B) Propellant-containing inhalation aerosols:

1) suspension aerosol:

2) suspension aerosol:

3) suspension aerosol:

4) suspension aerosol:

Claims

claims

1) Medicaments characterized by a content of one or more anticholinergics (1) in combination with one or more, preferably one compound of the general formula (2)

embedded image in which

R ^{1 is} hydrogen, methyl, ethyl, n-butyl, isobutyl, phenyl, 2-ethylphenyl,

2-i-propylphenyl, benzyl, 4-pyridyl, 2-pyridyl, -CO-phenyl, CN or together with R ² a butylene or pentylene bridge;

R ^{2 is} hydrogen, methyl, ethyl, or together with R ^{1 is} a butylene or pentylene bridge, or together with R an Emfachbmdung or a butylene bridge; R ^{3 is} hydrogen; R ^{4 is} methoxy;

R ^{5 is} cyclohexyl, phenyl, 3-methoxycarbonylphenyl, 4-methoxycarbonylphenyl,

3-carboxyphenyl, 4-carboxy-phenyl, CN, -COOH, -COOMe, -COOEt,

3,5-dichloro-pyridin-4-yl, 4-pyridyl or

4-pyridyl-N-oxide;

A is oxygen or -CH ₂ -;

B is oxygen or one of the groups -C (R ¹² ) (R ¹³ ) - or -CH (R ¹⁵ ) -CH (R ¹⁷ ) -;

D is a group selected from -CH ₂ -CH ₂ -, -CH (Ph) -CH ₂ -, -CONH-,

-CO-CH ₂ -, -CH = CH-, -C (Ph) = CH-, -C (CR ¹⁸ ) (CR ¹⁹ ) -X-, -C (R ^{, 9a} ) = Y-,

-CΞC- or phenylene;

R ^{12 is} hydrogen, methyl, ethyl, i-propyl, phenyl or -CH ₂ -COR ^x ;

R ^{13 is} hydrogen or, together with R ^2, a single bond or a butylene bridge;

R ^{15 is} hydrogen or together with R ¹⁷ a single bond; R ^{17 is} hydrogen or together with R ¹⁵ a single bond; R. 1'8 ^{δ is} hydrogen or methyl; R ^{19 is} hydrogen, methoxy, phenyl or CN; R ^{19a is} hydrogen, methyl or phenyl;

R ^{x is} hydroxy, ethoxy, benzyloxy, 2-phenylethyloxy, 4-methylpiperazin-1-yl,

4-phenylpiperazin-1-yl, N-tetrahydroisoquinolinyl, -NH-phenyl, -NH-benzyl,

-NH-CH - (4-methoxyphenyl), -NH-CH ₂ - (4-fluorophenyl),

-NH-CH ₂ - (4-chlorophenyl), -NH-CH ₂ - (2-chlorophenyl), -NH- (3-pyridyl) -, -NH-CH ₂ - (2-pyridyl), -NH-CH ₂ - (3-pyridyl), -NH-CH ₂ - (4-pyridyl),

-NH- (3,5-dichloro-pyridin-4-yl) or -NH- (2-pyrimidinyl); X is -CH ₂ -, -S- or -NH-

Y may be CH, CCN, CCOOEt or CHCONH, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts, optionally in the form of solvates or hydrates and optionally together with a pharmaceutically acceptable excipient.

2) A pharmaceutical composition according to claim 1, characterized in that 1 is selected from the group consisting of Tiotopiumsalzen, Oxitropiumsalzen or Ipratropiumsalzen, preferably Tiotropiumsalzen.

3) A pharmaceutical composition according to claim 2, characterized in that 1 is contained in the form of the chloride, bromide, iodide, methanesulfonate or para-toluenesulfonate, preferably in the form of the bromide.

4) A pharmaceutical composition according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2a,

embedded image in which

R is hydrogen, n-butyl, benzyl, 4-pyridyl, 2-pyridyl, -CO-phenyl or CN;

R ^ is hydrogen or together with R ¹³ a single bond;

R ^{5 is} cyclohexyl, phenyl, 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

R 12

Hydrogen, methyl, ethyl, i-propyl, phenyl or -CH ₂ -COR ^x ;

R 13 is hydrogen or together with R ² a single bond; R ^{x is} hydroxy, ethoxy, benzyloxy, 2-phenylethoxy, 4-methylpiperazin-1-yl,

4-phenylpiperazin-1-yl, N-tetrahydroisoquinolinyl, -NH-phenyl, -NH-benzyl,

-NH-CH ₂ - (4-methoxyphenyl), -NH-CH ₂ - (4-fluoro-phenyl),

-NH-CH ₂ - (4-chlorophenyl), -NH-CH ₂ - (2-chloro-phenyl), -NH- (3-pyridyl) -,

-NH-CH ₂ - (2-pyridyl), -NH-CH ₂ - (3-pyridyl), -NH-CH ₂ - (4-pyridyl), -NH- (3,5-dichloro-pyridin-4-yl) or -NH- (2-pyrimidinyl), optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

5) Medicament according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2b,

embedded image in which R ^{1 is} hydrogen, methyl, ethyl or 4-pyridyl, or together with R ^2, a butylene bridge;

R ^{2 is} hydrogen, methyl, ethyl, or together with R ¹ a butylene bridge, or together with R ¹³ a single bond;

R ^{5 is} 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

R ^{12 is} hydrogen or methyl;

R ^{13 is} hydrogen or together with R ² a single bond; R, 1 ^l 8 ^δ hydrogen or methyl;

R ^{19 is} hydrogen, methoxy, phenyl or CN;

X is -CH ₂ -, -S- or -NH-, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

6) Medicament according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2c,

where R ^{1 is} hydrogen, methyl, ethyl, phenyl, 4-pyridyl, 2-pyridyl, or together with R ² a butylene or pentylene bridge; R ^{2 is} hydrogen, methyl, ethyl, or together with R ^{1 is} a butylene or pentylene bridge, or together with R ^{13 is} a single bond; R ^{5 is} 3-methoxycarbonylphenyl, 4-methoxycarbonylphenyl, 3-carboxyphenyl,

7) A pharmaceutical composition according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2d,

where R ^{1 is} hydrogen, methyl, ethyl, n-butyl, i-butyl, phenyl, 2-ethylphenyl, 2-i-propylphenyl, 4-pyridyl, 2-pyridyl, -CO-phenyl, CN, or together with R ² a Butylene or pentylene bridge; R ^{2 is} hydrogen, methyl, ethyl, or together with R ^{1 is} a butylene or pentylene bridge, or together with R ^{13 is} a single bond or a butylene bridge;

R ^{5 is} phenyl, 3,5-dichloro-pyridin-4-yl or 4-pyridyl; R ^{12 is} hydrogen, methyl, phenyl or -CH ₂ -COR ^x ; R is hydrogen or together with R ² a single bond or a butylene bridge; R ^x ethoxy, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

8) Medicament according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2e,

embedded image in which

R is methyl or together with R ² a butylene or pentylene bridge;

R is methyl or together with R ¹ a butylene or pentylene bridge;

R is 3,5-dichloro-pyridin-4-yl or 4-pyridyl; D is a group selected from -CONH-, -CO-CH ₂ - or -CH = CH-; R ι hydrogen or together with R ¹⁷ a single bond;

R 17 is hydrogen or

"together with R ¹⁵ may mean a single bond, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

9) A pharmaceutical composition according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2f,

embedded image in which

R ^{5 is} 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

D may be a group selected from -CONH-, -CO-CH ₂ - or -CH = CH-, optionally in the form of the individual optical isomers, mixtures thereof or

Racemates and optionally in the form of their pharmacologically acceptable

Acid addition salts. 10) Medicament according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2g,

Wonn

R ^{5 is} 3,5-dichloro-pyridin-4-yl or 4-pyridyl;

D is a group selected from -CH ₂ -CH ₂ -, -CH (Ph) -CH ₂ -, -CONH-, -CO-CH ₂ -,

-CH = CH- or -C (Ph) = CH-, optionally in the form of the individual optical isomers, mixtures thereof or racemates and optionally in the form of their pharmacologically acceptable acid addition salts.

11.) Medicament according to claim 1, 2 or 3, characterized in that it is the compound of formula 2 is a compound of formula 2h,

wherein W is a radical selected from the group consisting of

or

12) Medicament according to one of claims 1 to 11, characterized in that the active compounds 1 and 2 are contained either together in a single dosage form or in two separate dosage forms.

13) Medicament according to one of claims 1 to 12, characterized in that the weight ratios of 1 to 2 in a range of 1: 300 to 50: 1, preferably from 1: 250 to 40: 1.

14) Medicament according to one of claims 1 to 13, characterized in that a single application of a dosage of the active ingredient combination 1 and 2 from 0.01 to 10000μg, preferably from 0.1 to 2000μg corresponds.

15) Medicament according to one of claims 1 to 14, characterized in that it is in the form of a suitable for inhalation Daπeichungsform.

16) A pharmaceutical composition according to claim 15, characterized in that it is a dosage form selected from the group of inhalable powder, propellant gas-containing metered dose inhalers and propellant-free inhalable solutions or suspensions. 17) A pharmaceutical composition according to claim 16, characterized in that it is an inhalable powder, which 1 and 2 in admixture with suitable physiologically acceptable excipients selected from the group consisting of monosaccharides, disaccharides, oligo- and polysaccharides, polyalcohols, salts, or mixtures of these excipients contains each other.

18) Inhalable powder according to claim 17, characterized in that the excipient has a maximum average particle size of up to 250μm, preferably between 10 and 150μm.

19) capsules characterized by a content of inhalable powder according to claim 17 or 18.

20) Medicament according to claim 16, characterized in that it is an inhalable powder which contains as ingredients only the active compounds 1 and 2.

21) A pharmaceutical composition according to claim 16, characterized in that it is a propellant-containing inhalation aerosol containing 1 and 2 in dissolved or dispersed form.

22) propellant-containing inhalable aerosol according to claim 21, characterized in that it contains as propellant hydrocarbons such as n-propane, n-butane or isobutane or halogenated hydrocarbons such as chlorinated and / or fluorinated derivatives of methane, ethane, propane, butane, cyclopropane or cyclobutane.

23) A propellant-containing inhalation aerosol according to claim 22, characterized in that the propellant gas is TG134a, TG227 or a mixture thereof.

24) Medicament according to claim 16, characterized in that it is a propellant-free inhalable solution or suspension, which as the solvent water,

Ethanol or a mixture of water and ethanol.

25) Inhalation solution or suspension according to claim 24, characterized in that the pH is 2-7, preferably 2-5. 26) Use of a capsule according to claim 19 in an inhaler, preferably in Handihaler.

27) Use of an inhalable solution according to any one of claims 24 or 25 for the fogging in an inhaler according to WO 91/14468 or a as in the figures

6a and 6b of WO 97/12687 described inhaler.

28) Use of a composition according to any one of claims 1 to 25 for the manufacture of a medicament for the treatment of inflammatory or obstructive airways diseases.